TY - JOUR
T1 - Low back pain scores correlate with the cytokine mRNA level in lumbar disc biopsies
T2 - a study of inflammatory markers in patients undergoing lumbar spinal fusion
AU - Aripaka, Sanjay S.
AU - Bech-Azeddine, R.
AU - Jørgensen, L. M.
AU - Chughtai, S. A.
AU - Gaarde, C.
AU - Bendix, T.
AU - Mikkelsen, J. D.
PY - 2021
Y1 - 2021
N2 - Purpose The molecular mechanism behind pain in degenerative disc disease (DDD) and chronic low back pain (LBP) patients is largely unknown. This present study examines the association of LBP and disability to mediators of the inflammatory cascade, as indexed by mRNA gene expression of pro-inflammatory cytokine markers in the intervertebral disc (IVD). Methods Biopsies of the annulus fibrosus (AF) and the nucleus pulposes (NP) from patients with DDD undergoing 1-2 level fusion surgery at L4/L5 or L5/S1 were obtained from total of 34 patients [9 M, 25 F] with average age of 53 [32-63]. The mRNA expression of TNF-alpha, IL-1 beta, and IL-6 in the AF and NP was analyzed using quantitative real-time polymerase chain reaction (RT-qPCR), and the expression level of these markers was correlated to the visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores (0-100) for pain and disability. Results We report a statistically significant positive correlation between pain intensity (VAS score) and the expression of TNF-alpha in both the AF (r = 0.54, p = 0.001) and NP (r = 0.40, p = 0.02), similarly with IL-1 beta in AF (r = 0.37, p = 0.02) and IL-6 in NP (r = 0.40, p = 0.02). In addition, we found significant positive correlation observed between disability score (ODI) and expression of IL-6 in both AF (r = 0.36, p = 0.03) and NP (r = 0.41, p = 0.01). Conclusion We conclude that the intensity of LBP and disability is associated with the level of inflammation in the disc.
AB - Purpose The molecular mechanism behind pain in degenerative disc disease (DDD) and chronic low back pain (LBP) patients is largely unknown. This present study examines the association of LBP and disability to mediators of the inflammatory cascade, as indexed by mRNA gene expression of pro-inflammatory cytokine markers in the intervertebral disc (IVD). Methods Biopsies of the annulus fibrosus (AF) and the nucleus pulposes (NP) from patients with DDD undergoing 1-2 level fusion surgery at L4/L5 or L5/S1 were obtained from total of 34 patients [9 M, 25 F] with average age of 53 [32-63]. The mRNA expression of TNF-alpha, IL-1 beta, and IL-6 in the AF and NP was analyzed using quantitative real-time polymerase chain reaction (RT-qPCR), and the expression level of these markers was correlated to the visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores (0-100) for pain and disability. Results We report a statistically significant positive correlation between pain intensity (VAS score) and the expression of TNF-alpha in both the AF (r = 0.54, p = 0.001) and NP (r = 0.40, p = 0.02), similarly with IL-1 beta in AF (r = 0.37, p = 0.02) and IL-6 in NP (r = 0.40, p = 0.02). In addition, we found significant positive correlation observed between disability score (ODI) and expression of IL-6 in both AF (r = 0.36, p = 0.03) and NP (r = 0.41, p = 0.01). Conclusion We conclude that the intensity of LBP and disability is associated with the level of inflammation in the disc.
KW - Intervertebral disc
KW - Low back pain
KW - Degenerative disc
KW - VAS score
KW - TNF-α
KW - INTERVERTEBRAL DISC
KW - TNF-ALPHA
KW - PROINFLAMMATORY CYTOKINE
KW - DEGENERATIVE CHANGES
U2 - 10.1007/s00586-021-06868-3
DO - 10.1007/s00586-021-06868-3
M3 - Journal article
C2 - 34023967
VL - 30
SP - 2967
EP - 2974
JO - European Spine Journal
JF - European Spine Journal
SN - 0940-6719
ER -